September 8, 2008

ER Urgent

In three months Ochsner Health System will open a new emergency room Uptown, bringing a small amount of relief to overcrowded ERs throughout the metropolitan area.

The $4 million project at Ochsner Baptist Medical Center will bring 12 more ER beds online by mid-December.

The addition comes as welcome news, but an increase of 12 beds won't fix an emergency health care system still reeling three years after Hurricane Katrina, said Dr. Jullette Saussy, director of Emergency Medical Services for the city of New Orleans.

"This will lessen the burden somewhat but we're still at critical overcrowding and have miles to go," Saussy said.

Katrina closed seven hospitals, forcing the remaining six to handle all emergency calls in Orleans, Jefferson and St. Bernard parishes. The result has been severely overcrowded emergency rooms.

The overcrowding has gotten so bad that ambulances with patients often have to wait up to three hours before a bed opens in the emergency department, Saussy said. And when paramedics are forced to wait, it means one less ambulance out in the field responding to 911 calls.

"It really puts public safety in a hard space because if I'm sitting there with Mrs. Jones who has stomach pain for three hours, someone's mother could be having a heart attack," Saussy said. "But I can't pull that ambulance away from the hospital until Mrs. Jones gets a bed. So now we're in a situation where potentially there will be a delayed response. It's an epidemic."

New Orleans EMS fielded about 40,000 calls per year before the storm. Last year, despite a 48 percent population drop, they took the same amount but had seven fewer emergency rooms to deliver patients.

Charity and University hospitals combined had 76 ER beds before the storm. Today, University has 45 and expects to reach 65 by the summer of 2009, said Dr. Cathi Fontenot, medical director for the Medical Center of Louisiana at New Orleans.

Saussy said she has no idea why the volume of calls has remained the same but she is sure of one thing -- the crush of new patients has paralyzed emergency services.

Pre-Katrina 2005, ambulances were kept waiting at ERs for a total of 200 hours per month. This June, the wait time jumped almost 300 percent to 588 hours. That means ambulances are out of service for 20 hours a day waiting to drop off patients compared with just seven hours before the storm.

"Any way you slice this, when you cut out the 300,000 patient visits to the Charity ER, you pretty much cut off the city's legs and then tell us to run a marathon," Saussy said. "The wait times are absolutely crippling our operations. We tell the city about the crisis on a daily basis. We've been to Washington and written letters. We talk to local hospitals, but their hands are tied financially. The bottom line is that the people who are suffering are the patients."

As Robert Wolterman, CEO of Ochsner Baptist Medical Center, walks through the unfinished halls of what will soon be the new ER, he echoes Saussy's concerns. Emergency services in New Orleans have reached a critical stage. And while 12 beds won't solve the problem, it can only help, he said.

The Baptist emergency room expects to see up to 20,000 patient visits in its first year, or 40 to 50 a day.

In addition to the new emergency room, Ochsner Baptist will add 30 inpatient beds by the end of the year bringing the total to 55 beds, all of which will be private rooms.

Since its purchase in October 2006, Ochsner has invested more than $30 million in revitalizing the Baptist campus. Despite the large investment, Wolterman is aware of the criticism that has been leveled at Ochsner -- it has taken too long to reopen the Uptown facility that saw 60 percent of its campus sustain flood damage. Of the 600 on-staff doctors at Baptist pre-Katrina, almost 90 percent did not return.

It has been a massive revitalization process that did not begin until October 2006, Wolterman said.

Today, Baptist has 300 physicians and is adding 20 a month. As the need grows in the city, Ochsner Baptist has the capacity to add to more than 100 in-patient beds. And by 2012, it hopes to reopen the old hospital wing as a continuing care retirement community.

"We understand what this hospital means to this community," Wolterman said. "Not a day goes by when someone doesn't come up to me and tells me how their children were born here and that their parents were cared for by Baptist. We hope people realize that it is coming back to life."